#Geriatric Assessment

[momlovesyoubest]

End of Life-When Do You Facilitation?

Therapist Why do some families need facilitation of a family meeting at the end of life? With the help of a neutral third-party facilitator, families work together to resolve their differences or solve a problem they could not address satisfactorily without help. Find out more in my newest free Webinar on February 25th 2005 These family differences especially happen to dysfunctional families but…

[spookybunnybabe]

i need like a recording of rimmer telling me to go to work because oh boy i want to get into an accident so i don't have to go

[sevsgiirl]

— piss her off ‘til she hates me, pt. 1

pt. 2, pt. 3

mechanic!sevika x reader. men and minors dni.

synopsis: when the vacant house next to sevika’s finally got new tenants she didn’t think much of it. as long as her new neighbors didn’t cause any trouble, all was well. that is until she found out the neighbor had a young daughter.

word count: 9k words.

tags: age difference, alternate universe, mechanic!sevika, brat!reader, enemies to lovers, oral sex, dom!sevika, sub!reader, pet names, scissoring, hate sex, vaginal fingering.

note: for clarification, reader is 20 years old while sevika is her canon age in this (38-40)

you can check out the fic playlist here.

sevika wasn’t the buddy-buddy type when it came to her neighbors.

as someone who mostly kept to herself, she preferred to be left to her own devices, granted she wasn’t necessarily unapproachable. if you’d knock on her door to borrow some tools, she’d likely lend you hers. have some problems with your plumbing? on a good day, she’d offer to fix it herself.

she’d even attend the annual neighborhood barbecue sometimes, but she wasn’t the type to knock on doors and welcome the new people who had just moved in with freshly baked cookies. that’s something she left vander to do.

so when the vacant house adjacent to hers finally got some new occupants after the previous tenant moved out 3 months ago (a friendly old woman named babette who she would never admit to missing, she and her homemade lasagna she’d offer sevika for dinner) she didn’t think much of it.

but she was curious, so she peeked through her blinds to get a good look at the new tenants, trying to assess what she had to deal with.

when she looked, she was simply greeted by a man who looked to be in his 50s hauling out boxes - slouched posture, flannel button-up, and leather boots. he had the tiredness in his eyes that indicated he was just an everyday samaritan. she was happy about that because she liked her peace.

but before she was about to close her blinds again, a new figure caught her eye. this one younger, miles younger, who sported beaten up doc martens, ripped black shorts that ridden up too high around the rear area that sevika was quick to avert her gaze when she stared too long, and a loose fitted top that was sliced around one shoulder, leaving it exposed.

with painted black nails and eyelids adorned with dark eye shadow, sevika watched as you got out of the front seat of the moving truck and inspected the house in front of you with an intense gaze. before a small smirk made its way to your face, the kind she knew only meant trouble.

“looks great, dad!”

sevika couldn’t believe this.

𐙚 ˙ ⋆ .˚

it’s not that sevika wasn’t fond of people younger than her.

she was just too old to handle any of their shit. not that being forty-one was geriatric by any means, but she liked her peace, and she couldn’t necessarily have that if she had someone twice younger than her living just down the block. the possibility of house parties being thrown already sending shivers down her spine.

she already had vander’s daughters out of her hair, and even then she heard from him they’re coming back home for their semester break this week so that’s another problem to deal with. you couldn’t be too far from their age range either, probably closer to vander’s eldest, violet. which relieved her in a way.

she hasn’t even spoken to you yet but she dreads the day she’ll ever need to. but it seems as though your father heard her prayers because it didn’t take long after the moving truck drove off when a sudden knock came from her front door, making her raise her eyebrow.

she opened it and just her luck she was greeted by your father, a soft smile on his face as he gave her a gentle wave “hi there, me and my daughter just moved in and I wanted to formally introduce myself.”

sevika gave him a curt nod “I noticed. welcome to the neighborhood.”

again, she wasn’t the type to knock on people’s doors and give them a formal introduction to the whole damn block. the only way she ever got to know people was when word got around about her being the town’s mechanic. she was mostly acquainted with the fathers and uncles, meanwhile the women her age she preferred to sleep with. occasional flings here and there, nothing serious.

the only people she’d consider her friends were vander and silco, and perhaps some of her co-workers back at the mechanic’s shop but they lived elsewhere.

it was hard for her to truly get along with someone, albeit she isn’t opposed to making friends, it’s just something that takes time. she’s a tough cookie.

your father, on the other hand, seemed civil enough. sevika didn’t even notice the container he carried with him until he lifted it “well, my daughter baked some brownies and I thought maybe I’d give you some. wouldn’t hurt to befriend a few folks on the first day, and well, you do live next door.”

she eyed the container while she debated whether to return the gesture or not, and as she thought long and hard about it, she didn’t want to appear like an asshole.

“care for a cup of coffee, then?”

and that’s how she found herself sitting across from your father at her kitchen table, with him sipping his coffee while she chugged her third can of beer of the day.

despite herself, your father was pretty pleasant. thirty minutes of mundane chatting and she’s already gotten to know quite a bit about him - widowed and left to take care of his only daughter, your mother dying while you were only eleven years old. breast cancer. she offered a bit of sympathy which he appreciated.

“never got remarried?” she couldn’t help but ask.

your father laughed softly, shaking his head “no, can’t. when she died a part of me died with her, and I don’t think anybody can truly fill that void. plus I don’t think my daughter would be on board. not that she wouldn’t let me, she never cared but I know she still thinks about her mom a lot.”

sevika let out a hum “I get it. my mom died when I was young too. it never got easier.”

“it doesn’t.” he replied “she’s twenty now. a sophomore in college but sometimes I do feel like she’s clinging onto that part of herself when her mom was still alive. she became a bit rebellious after that. threw herself to drinking at sixteen, I tried to stop her which worked when she finally became eighteen, but her habits still kick in.”

sevika would be lying if she said she didn’t feel bad for the old man. she didn’t have any kids and quite frankly, has no intention of having any in the near future, but she can only imagine how difficult it’d be to see your child spiral like that and have it be out of your control.

“she’s doing a lot better now?” she asked.

your father nodded, although it seemed a bit uncertain “I think so. she’s on her mid-semester break and will be back by the end of the month.”

sevika sighed internally at that, at least she won’t have to worry about you potentially becoming a problem for too long.

her and your dad conversed a bit more after that - about how he decided to move here because he a got new job in town, and how your college was located two hours away, making him think that your visits would be limited given how you don’t like traveling for long hours (again, another win for her) he also asked her about her prosthetic arm ‘bad car crash. got stuck and had to get it amputated’ she explained and he gave a sympathetic look in return.

soon, she led him up to her front door. it was nearing the evening anyway, but she surprisingly appreciated the company.

“sorry if I took up much of your time, sevika.” your father apologized and she smiled. a genuine one.

“it’s no bother. if you ever need help don’t be afraid to ask.” sevika said and she meant it.

your father offered a grateful nod, walking down her driveway and next door to his house. when sevika looked, there you were waiting for him.

you decided to change into something more comfortable since you arrived. a tight-fitted black tank top with thin straps and grey cotton shorts that exposed your legs to the cold air. you didn’t seem to be wearing a bra either and given the weather, she could notice your nipples poking through the fabric even from where she stood.

sevika shook her head. goddammit . she just made friends with your old man and here she was ogling at his daughter. she wasn’t even supposed to like you.

as your father walked up to your front door he sent her one last wave goodbye, which made you finally look at her.

for that brief moment, your eyes locked. she couldn’t decipher that look on your face when you studied her, arms crossed as you cocked your head to side while your father spoke “she’s our next door neighbor, sweetheart. sevika, meet my daughter!” she only smiled awkwardly while you continued staring at her.

suddenly, that same smirk made its way to your face again, opening your mouth to respond “hi sevika,” you said, your voice sultry and sickeningly sweet. sevika hated that it did something to her.

you didn’t give her time to acknowledge your greeting before you turned on your heel and went back inside, and she didn’t even realize her chest tightened the entire time you two made eye contact until you were finally out of sight, making her breathe normally again.

[havenesc]

🌈🌩️

(wipwed ask meme)

thank you for sending in an ask!! <3 sorry this is all night watch FDSGB

🌈 Share something soft/fluffy from your WIP.

Jason gently rests his free hand on Percy's back as Percy keeps his forehead on Jason's chest, which earns him a flinch amongst the tremors, but Percy relaxes into it. There's little else but the thrum of their pulses, the sound of their breathing slowly coming down to something normal. Jason stares up at the ceiling through heavily-lidded eyes, trying to debate the merit of what would happen if he kissed Percy's head.

🌩️ Share something funny/cracky from your WIP.

"Okay," Percy says, and he has to clear his throat. His eyes flicker over Jason's shoulder. "Should probably take this away from the door, though, before Mrs. Leflan knows I'm home."

Mrs. Leflan is an eighty-eight year old retiree, sporting coke-bottle glasses that are almost as thick as Jason's wrist, and has utterly deemed herself useless without Percy's help. Jason huffs through his nose, blush high on his cheeks despite the left-field mention of Percy's neighbor. "You mean you don't want to teach her how to use her microwave?" he asks, and with a pause, "Again?"

"You do one nice thing and now you're a personal handbook on anything invented after the lightbulb," Percy sniffs, knocking his knuckles idly on Jason's shoulder as if to say, hurry up. "And she will come over. Move."

"Maybe she's lonely," Jason says, smiling innocuously.

"Get bent, Jay," Percy says, flashing teeth. "I don't want to assess my geriatric neighbor for a heart attack because she saw my hand down your —" He stops, considers the state of Jason's pupils, and shakes his head. "—Nevermind. Just. Whatever we're doing. Not here. Fuck you, you know what I mean."

[the-empress-7]

Remember too Markle was in her 40's when she had allegedly Lili. A geriatric high risk pregnancy. The yanking on the alleged belly is especially unbelievable. Sam said she had eggs frozen in her thirties and that's believable. Do you think Ms. Perfection would risk a child with downs? The risk of such at 40 is significant. Nope, she used those frozen eggs with a surrogate.

I like to think the kids are biologically theirs but then again we haven’t really seen them to really make that assessment.

[sionisjaune]

59. interrupted declaration of love + 90. unexpected virgin....? -kane :)

The way I've been seeing this url in my notes for WEEKS and did not put together that it was you... here you go:

Lewis is cooking dinner, monologuing about what happened when he met Rick Owens, how he tried on the giant acrylic platform heels and nearly tumbled flat on his face. Mick watches him gesticulate affably in front of the floor-to-ceiling kitchen window, the smoggy skyline of New York unfurling behind him. Mick clenches his fists under the table, listening to Lewis explain how he wants to try the shoes again, wants to practice in them so he can wear them through the paddock and piss the geriatric fucking oil barons off—Lewis’s words. Mick feels bad about interrupting, but he has to say it before he loses the nerve. 

“Lewis,” he says, abortively. He feels his cheeks heating. Now that he’s paused, it’s going to be a thousand times harder to get the words out. He sets his jaw and makes himself say it. The words exit his mouth in a jumble: “I have—feelings for you.” 

Lewis drops the spatula he was working with, and his head snaps towards Mick. Mick’s heart nearly arrests right there, under Lewis’s assessing gaze. The careful opaqueness of Lewis’s face is going to break his heart—Mick knows it. He readies himself for the worst possible reaction, which he figures will be pity. that someone like Mick loves someone like Lewis. 

Lewis blinks. The pan on the stovetop steams and sizzles. “Oh thank God,” says Lewis. “I thought I was wrong and that I invited you here for nothing.” He wipes his brow, cracking a relieved smile. Something tender and happy unfolds inside Mick’s chest. He watches Lewis flick off the stove while Mick’s hands shake, his fingertips pressed into his thighs. 

“Let’s not even bother with this,” says Lewis, nudging the pan off the stove. “I want to fuck you so badly. God. Can I say that?” 

All of a sudden Lewis is crossing the open-concept apartment, his bare feet on the ridiculously ornate tiles, and Mick is still frozen at the dining room table, distantly aware that his mouth has dropped open and that he must be staring at Lewis with awe in his eyes. It’s almost like he can’t believe it. He doesn’t believe it, even though he heard it from Lewis’s mouth. 

Lewis pauses half a metre away from Mick. Mick finds himself tilting his head up to look Lewis in the eye. 

“I thought Seb was going to kill me,” said Lewis. “I felt so… dirty? I haven’t felt that way for… at least a decade.” He takes another step towards Mick and reaches for Mick’s jaw. “Is this okay?” 

Mick feels himself nod. Then Lewis’s lips are meeting his, his mouth is opening to Mick’s, and Mick is hauling himself out of his chair to mold his body to Lewis’s while he kisses him. Lewis rakes a hand through Mick’s scalp, fingers closing around a fistful of hair, and Mick lets himself be led to the sofa. Lewis pushes him down onto it, their mouths never parting, and climbs on top of Mick. 

“You’re so fucking hot,” says Lewis, when he pushes Mick’s shirt up above his nipples. Mick experiences a double rush of arousal at the feeling of Lewis’s hand tracing his abdomen and the idea that Lewis thinks he’s hot. 

Lewis ducks back in to kiss him again, and feeling bold, Mick reaches around to hook a few fingers into the belt loops on Lewis’s jeans and pull his hips against Mick’s. Lewis groans, rolling his hips into Mick’s erection, and a shock of ecstasy pulses up Mick’s spine. He momentarily loses his coordination and finds his lips mouthing messily at Lewis’s beard. 

Lewis chuckles like it amuses him, and then his hand is slipping down Mick’s abs and towards the elastic waistband that’s peeking out of Mick’s jeans. “Tommy—I like it,” Lewis murmurs, into Mick’s neck. His hand travels further, thumbing over the button of Mick’s jeans, popping it open, and then��

“Wait,” says Mick, tearing his mouth from Lewis’s. “Just. Hold on a second.” He swallows, working up the nerve for the second time this evening. “I’ve… never. With a guy.” 

“Oh,” says Lewis, pulling back. There’s an impossible flush on his cheeks. His hand remains where it is. Mick swears that his pupils have dilated, that there's a crazed light shining behind his eyes. “Okay,” he tilts his head from side to side. “I can work with that.” He dives back in.

[covid-safer-hotties]

Reference saved in our archive

Abstract Background The relationship between COVID-19 infection and a possible increased likelihood of older adults developing new-onset dementia (NOD) remains elusive.

Methods A thorough search was performed across several databases including MEDLINE/PubMed, PsycINFO, Scopus, medRxiv, and PQDT Global for studies published in English from January 2020 to December 2023. Only original investigations exploring the link between COVID-19 infection and NOD were selected for inclusion. We assessed the risk of developing NOD, using Risk Ratio (RR) for measurement. Control groups were categorized as: (i) a non-COVID cohort with other respiratory infections [control group (C1)]; and (ii) a non-COVID cohort with otherwise unspecified health status [control group (C2)]. Follow-up periods were divided into intervals of 3, 6, 12, and 24 months post-COVID.

Results 11 studies (involving 939,824 post-COVID-19 survivors and 6,765,117 controls) were included in the review. Across a median observation period of 12 months post-COVID, the overall incidence of NOD was about 1.82% in the COVID-infected group, compared to 0.35% in the non-COVID-infected group. The overall pooled meta-analysis showed a significantly increased NOD risk among COVID-19 older adult survivors compared to non-COVID-19 controls (RR = 1.58, 95% CI 1.21–2.08). Similar increased NOD risks were observed in subgroup analyses restricted to an observational period of 12 months (RR = 1.56, 95% CI 1.21–2.01), as well as in five studies that employed propensity score matching to sufficiently and effectively control for multiple confounding covariates (RR = 1.46, 95% CI 1.10–1.94). COVID-19 group and C1 group shared a comparably increased risk of developing NOD (overall RR = 1.13, 95% CI 0.92–1.38).

Discussion Under normal circumstances, we believe that COVID-19 infection is likely to be a risk factor for developing NOD in older adults over time. While the increased NOD risk due to COVID-19 infection appears to be similar to that associated with other respiratory infections, it warrants and necessitates investigation with longer observations.

[momlovesyoubest]

10 Reminiscence Therapy Tools, Technology, and Techniques for New Year

  Use Reminiscence therapy to capture family tales of aging parents or clients in the New Year. Do you use reminiscence therapy? Do you know how to use a reminiscence tool? Have you lost an aging parent and wished you had asked them more questions to reminisce about their past, family history, and childhood? Have you dabbled in ancestry and realized -too late- that you should have listened…

[morning-sun-brah]

Hello! I just read that Mafia au snippet and I need more of this. I could see the possible yearning between Leo and Vivian ugh and it’s delicious nomnom

THANK YOU SO MUCH!

Here, have a treat!

<Part 1

Mafia AU, Part 2

Betty returned to the office two days later, her husband in stable condition, and when she did Leon told her that he would, with no exceptions, be the one to make bank deposits from then on (and also she was getting a raise- being a trophy wife for a geriatric seemed like hard work). 

“Anything to lighten the load,” he’d insisted. “You’ve got too much on your plate, Betts.” 

Betty had looked half skeptical, half relieved. It was the easiest part of her job, so Leon could understand the confusion, and she’d tried to show him how to download the bank app on his phone but he’d just waved her away and shook his head. 

“I got it,” he insisted.

Was he being a fool? Probably. Only a fool would trek their way into a bank just on the off-chance of talking to a pretty woman, but Leon had done worse. He was sure he had, anyway- he was close to forty, and he’d gotten into plenty of trouble with women and men alike. Maybe not with the promise of so little, though. A bit of prolonged flirting, with a woman he didn’t even know, seemed like the kind of bone a much younger man would go after. Which implied he was some sort of dog, but Leon wasn’t exactly rushing to rectify his own assessment.   

He returned to the bank a week later, a check in hand and grinning widely from the back of the line while he watched Vivian wait on customers. Leon had half convinced himself that his overactive imagination had exaggerated how pretty she was, how much he enjoyed looking at her- but on second sight he found her even more to his liking. Which was mildly surprising, since she looked a little run-ragged. Hair all piled on the top of her head in a crooked bun, only a swipe of lip gloss and a brush of mascara on her face, and dark bags under her eyes from behind the rims of her glasses (black and thick-framed today). 

Take her home and really exhaust her was his first thought, and he blinked at the idea before shoving it deep down, until it resided somewhere at his feet. 

He was a little worried, too, that she’d maybe looked him up. That when she’d call on him, it would be with a wealth of professionalism, maybe even fear, and he knew that if that were the case the game would be over. He’d have to download some stupid app to his phone and follow through with his promise to deposit checks, because there wasn’t a point in coming to the bank and talking to Vivian if she wasn’t going to treat him exactly how she had been- not knowing who or what he was. 

But her voice rang out when it was his turn in line, and he knew she still wasn’t clued in.

“Come on, big guy.” 

Immediately Leo was beaming- a lance of delight running through him that she remembered him, that she stuck with the moniker of big guy. That she didn’t know. 

She didn’t know. 

“Vivian,” he greeted, sliding over his check, leaning against her counter.  

“Oh my god,” she began, huffing out a breath that blew a stray chunk of hair from her forehead. “Did you even fill out a slip?!” 

“I did not.” 

“I should make you go to the back of the line,” she grumbled, grabbing a blank deposit slip and shoving it under his snout. “Go on,” she insisted. “Fill it out! I’m not doing it for you!” 

Leo pulled a frown. “But you have such nice handwriting,” he simpered. 

“Ew,” Vivian said, mouth opening and tongue lolling out to imitate retching. “Please, I’m not your mother. Fill out your own shit.” 

Leon chuckled, taking a bank pen and leaning over the counter a little more to fill in the blank spaces- one finger holding the slip steady since he’d once again forewent the prosthetic (and Donnie really was going to hand him his ass if he didn’t start wearing it more often). He glanced at her as he scrawled out the information, and Vivian gave him a little glare. 

“What?!” Leo asked indignantly. 

Not bothering to deny that she indeed had been glaring at him, Vivian snapped, “I’m mad at you.” 

Pausing midway through signing his name, Leo gave her an incredulous, baffled look. 

“What the hell did I do?!” he asked in a bewildered voice, a smile still tugging the corners of his lips. 

Vivian’s eyes slotted thinner. “Well for one, you didn’t bring me coffee,” she said, and Leon had the good grace to wince. 

“Shit, yeah, that's my bad, Viv.” 

If she had anything to say about him calling her Viv, she didn’t voice it- didn’t even look as though it bothered her in the slightest. Instead, she continued, “I don’t think you understand. Our coffee pot broke, and I haven’t had any caffeine. Do you know how excited I was when I saw you in line? I thought for sure you’d brought me coffee- seeing as I let you have mine when you needed it.” 

“You noticed me in line?” Leon asked brightly, ignoring the rest of her words and grinning when she snarled at him. 

“You’re too tall, how could I not notice you?”  

Leo chuckled and finished signing his name, tsking when she snatched the slip from his hand. 

“Could have given me a papercut,” he scolded, snorting when Vivian grumbled, then added, “Why else are you mad at me, sweetheart?” 

“Ugh, because your face is so punchable,” Vivian answered, tapping on her keyboard. 

Leon pouted- something she didn’t even notice because she wasn’t looking at him, and the expression melted into a frown. “C’mon, gorgeous, what did I do?” He prodded, voice dipping into sincerity. 

She stopped typing to turn fully in her seat, eyes narrowed at him, “Flattery will get you nowhere.” 

Leo’s brow ridge quirked. “I find it’s gotten me everywhere, actually. And who says it’s flattery? Who says it’s not the truth?” 

Vivian snorted. “Fine. Remember you asked for this.” She heaved a sigh and began. “My alarm went off a half hour before I was supposed to be here this morning, so I was an hour late. I look like death, I haven’t had coffee, my first customer yelled at me for twenty minutes, and you decided to come in today, of all days.” Vivian glared and added, “It’s rude.” 

Leo let a slow, wicked little smile stretch across his face. 

“So let me get this straight,” he said, eyes alight. “You’re mad at me because I came in and saw you… What? Not at your best?” 

Something that felt a lot like excitement alighted in his chest when, instead of backtracking or denying his words, Vivian nodded. 

“Yeah, exactly.” 

“But I already have a terrible first impression of you,” Leon quipped. 

“Yeah, but I looked good, at least!” Vivian insisted, a little hint of a smile tugging at the corners of her lips. “Now you have a terrible impression of me and I look like shit.” 

Leo couldn’t help but bark out a laugh, not noticing how some of the other customers who were still in line flinched at the sound. He gave her a crooked smile. “Vivian,” he started, waiting until she looked at him before adding in a very serious tone, “You’re absolutely right. You look like shit.” 

Vivian rolled her eyes. “Oh shut up,” she sniped. 

Chuckling as her fingers tapped almost violently on her keyboard, Leo shook his head and said, “If I didn’t know any better, I’d say you were fishing for compliments.” 

She only responded by rolling her eyes again, casting him a dark glare, and Leon let his gaze travel over her desk. There was a little pot of fake flowers, a picture frame that was turned so he couldn't see who looked out from it, a blue stress ball that looked as though it had seen better days, and- 

“I’m sorry, is that a Rancor?” 

Vivian’s fingers paused. 

“And?” 

“You have a Rancor action figure at your desk?” 

“He’s my little pet.” 

Leo’s brow ridge went high on his forehead, casting her a dubious look. 

“Hey, judgy, don’t give me that look.” 

“I’m not judging.” 

“You shouldn’t,” Vivian insisted. “Seeing as you knew exactly what it was you nerd.” 

“Oh, I don’t think I’d be tossing unkind words when I’m not the one with a fucking Rancor sitting on my desk.” 

Vivian gave a little pout. “His name is Jerry.” 

Leon blinked at her. “Jerry.” 

“Yes. I think it’s funny to give big intimidating things normal names.” 

“Am I a big intimidating thing?” 

“No,” Vivian sniffed. “You’re a gremlin.” 

“God, the confidence boost I get talking to you.” 

She raised an arched brow at him and didn’t respond (though she did grumble out something that sounded a lot like now who’s fishing for compliments), and he drummed his fingers on her counter, just to be annoying. 

“I know you aren’t rushing me,” she deadpanned, cutting him a withering glare and slowing her typing down to a snail's pace. 

“I would never rush such a well-put-together lady,” he replied with snark. 

“I’m going to freeze your account.”

Something, maybe pity, finally tugged at Leon, and he gave a sigh. “C’mon now, Viv,” Leo murmured. “You know you look good.”

Finally, she blushed, and Leo leered at her when she ignored him to go back to typing.

There was a bit more aggressive tapping, and then she was sliding his check into the desktop safe that sat next to her. Just before she handed him his receipt she said, “You come in here again without my coffee, and I’ll ruin your life.” 

Leon scoffed and snatched the paper from her. 

“I’m tempted to see if you can.”

@starrcrossrose and I appreciate the love. <3

Also, what kind of man drinks up some poor woman's coffee and then doesn't bring her cup when he promised to? Degenerate behavior.

[anaswaraseo]

Clinical Nutrition & Dietetics: Science for Better Health

Clinical Nutrition and Dietetics is a specialized field that uses nutrition to manage and prevent disease, improve health outcomes, and promote overall well-being. Here’s a deep dive into the essential aspects of this field:

What is Clinical Nutrition and Dietetics?

Clinical Nutrition and Dietetics involves assessing, diagnosing, and treating nutrition-related health issues. Dietitians and clinical nutritionists work closely with patients to develop dietary plans tailored to their medical conditions, lifestyle, and specific health goals.

Key Areas of Clinical Nutrition and Dietetics

Medical Nutrition Therapy (MNT): MNT is the cornerstone of clinical dietetics, involving specialized dietary interventions based on scientific evidence. It’s used to treat chronic illnesses like diabetes, cardiovascular disease, cancer, and kidney disease.

Nutritional Assessment: This includes evaluating a patient’s diet, medical history, physical health, and lab results to create personalized nutrition plans. Tools include BMI, body composition analysis, dietary history, and blood tests to assess nutrient levels.

Therapeutic Diets: Dietitians often develop therapeutic diets to manage health conditions, which can include:

Low-sodium diets for hypertension and heart health.

Low-glycemic diets for managing diabetes.

High-protein diets for malnutrition and muscle recovery.

Renal Diets for kidney disease patients to reduce the intake of specific nutrients.

Pediatric and Geriatric Nutrition: Clinical dietitians specialize in creating age-appropriate nutritional plans for children and elderly patients, addressing issues like growth, development, bone health, and cognitive function.

Mental Health and Nutrition: Dietitians are increasingly focusing on the connection between nutrition and mental health, as certain nutrients (e.g., omega-3s, and B vitamins) can impact mood and cognitive function.

Emerging Areas in Clinical Nutrition

Functional Foods and Nutraceuticals: Functional foods (like probiotics) and nutraceuticals (such as dietary supplements) are increasingly used in clinical nutrition to support specific health outcomes, such as immune function or gut health.

Personalized Nutrition and Genomics: Nutrigenomics studies how genes influence individual responses to nutrients, leading to personalized nutrition plans based on a patient’s genetic makeup. This method works especially well for treating chronic illnesses.

Integrative and Holistic Nutrition: Integrative nutrition considers lifestyle factors, stress, and mental health along with diet, promoting a more holistic approach to patient care.

Plant-Based Diets: The use of plant-based diets in clinical settings is becoming popular for their benefits in reducing inflammation, improving heart health, and supporting weight management.

Role of Clinical Dietitians in Healthcare Settings

Hospitals: Clinical dietitians are essential in hospitals, where they design dietary plans for patients recovering from surgeries, dealing with chronic illnesses, or undergoing treatment that affects their nutritional status.

Outpatient Clinics: Many dietitians work in clinics, providing ongoing support for patients with chronic conditions like diabetes or high cholesterol.

Rehabilitation Centers: Nutritionists here help patients with recovery, focusing on high-calorie or high-protein diets to promote healing.

Skills for Clinical Dietitians

Analytical Skills: Strong understanding of biochemistry and physiology to interpret lab data and develop dietary plans. Counseling and Communication: The ability to communicate effectively with patients to promote adherence to dietary plans.

Evidence-Based Practice: Staying updated with the latest research to provide science-backed advice. Career Opportunities

Clinical dietitian: employed by long-term care homes, clinics, or hospitals.

Nutrition Researcher: Contributing to research on disease prevention and dietary interventions.

Consultant Dietitian: Providing freelance or consultancy services for healthcare facilities, wellness centers, or private clients.

Corporate Wellness Programs: Supporting employees’ health and well-being through nutritional guidance in corporate settings.

Conclusion

In conclusion, Clinical Nutrition and Dietetics is a transformative field that bridges the gap between nutrition science and patient care, offering personalized approaches to health and wellness. By understanding the intricate relationship between diet, disease, and overall health, clinical dietitians play a crucial role in improving health outcomes and enhancing quality of life. As new research and innovations in nutrition continue to emerge, this field remains essential in advancing preventive care, supporting disease management, and promoting holistic well-being.

[ystk-archive]

What do you feel about GAME, STEP, MORE! MORE! MORE! and Supreme Show turning 15 this year? How about Japanese electropop in 2008 generally and the album releases that you like from that year?

I feel old and I miss the online fan communities that existed for this music back then and wish I could go back in time and share all the things I have now with those people -- god, the discussions would be amazing lol. I also wish I'd had the presence of mind to save more things at the time when I was there.

Greater than my personal geriatric "what ifs," realizing how old and forgotten this music is makes me sort of sad. Though Japanese music is widely accused of being derivative of the west -- and there are small kernels of truth to that, if I have to be honest -- there is something special about the dance music over there but it's overshadowed by other J-music trends like city pop and neo-Shibuya-kei and as a result Japanese electronic music receives no real accolades or interest from abroad. This isn't even touching on how badly electro-pop failed to garner a large audience domestically either, so many artists were picked up by major labels and then dropped like a deadweight because they didn't pull instant Polyrhythm-level cultural capital. I suppose you could say those artists and the style of music itself have no intrinsic appeal and that's a valid assessment too though...

I could easily write a lot more but anyway, SAWA's Time&Space EP is one of the 2008 releases that was an instant classic to me and I always think of it when I consider that year in music. (And props to her for maintaining her own YouTube channel and uploading her past music videos in 1080p, sure wish a certain somebody would do the same!)

[oh-littlelamb]

Just to catch up on this lamb life, right now:

I believe I said before that I am in an OT graduation course (university) this year is my internship year.

A lot of things happened, but in my resume, I am in pediatrics and "hospital context".

The teacher who is responsible for getting all the paperwork done made some mistakes, and basically, I am running out of time and probably will have some troubles with my hours.

All 3 pediatrics teachers basically said to be to go back to my neurologist and get an autism assessment done (again) because I have very poor communication skills.

I started with a new pediatrics teacher, and her specialist is with kids on the spectrum. My patients are most non-verbal kids (I have a total of 10 patients, but only 2 actually are verbal)

I am having lots of trouble with fainting + headaches, but I didn't miss any days of my internship until now.

I am having some trouble with regressing voluntary, mostly, not being in a safe environment, I ended up having some episodes with impure regression (involuntary).

Next semester, I will be interning in "mental health" and "Adult Rehabilitation + geriatrics".

Oh, oh, I started to catch up again in witchy stuff, tarot reading, and books.

[mariacallous]

In the mid-1980s, although its dissolution was nearly at hand, few were predicting the complete demise of the Soviet Union. But when it came to the politics of leadership succession, a country that had been widely feared or respected for decades had already begun making a mockery of itself.

By the late 1970s, Leonid Brezhnev, the once-vigorous man who had shunted aside Nikita Khrushchev in 1964 to lead the country, had been reduced to a shell of his former self by years of heavy smoking, hard drinking, and emphysema. He visibly huffed and puffed as he walked with a shuffling gait, and he occasionally slurred his words or displayed obvious memory lapses.

After Brezhnev, things in Moscow only got worse. He was succeeded by the former intelligence chief, Yuri Andropov, who was regarded in almost equal measure as a reformist thinker and as a corrupt and sternly authoritarian figure. No one knows which of these traits might have prevailed over time, because time was the one thing Andropov did not have. He died at age 69, his power lasting only 15 months, during the last year of which he suffered total kidney failure.

Andropov was followed by the scarcely-remembered Konstantin Chernenko, another heavy smoker afflicted with emphysema and heart problems. His rule only lasted for 13 months. The historian John Lewis Gaddis said of the ephemeral Chernenko that he was “an enfeebled geriatric so zombie-like as to be beyond assessing intelligence reports, alarming or not.” Chernenko’s death in office paved the way in 1985, finally, for the comparatively youthful Mikhail Gorbachev.

But by then it was the Soviet system itself that was running out of time.

Existential crises linked to the vagaries of succession politics are typically thought to be the province of authoritarian systems that lack regular and transparent rules for the passing of power from one leader to the next. But for the past three years, it is precisely this specter that has hung over the world’s oldest electoral democracy, the United States.

This has never been clearer than in the past two weeks. First, the mental competence of President Joe Biden, 81, was called into question in a report by Robert Hur, a special counsel appointed to look into the president’s improper handling of classified documents, and then by new flights of disturbing rhetoric by former President Donald Trump, 77, raised renewed profound questions—or should have—about his own fitness for presidential office. Describing a real or imagined conversation about NATO dues with a European leader, Trump related: “I said: ‘You didn’t pay? You’re delinquent?’ … ‘No, I would not protect you, in fact I would encourage [Russia] to do whatever they want. You gotta pay.’”

There is a dismaying amount of confusion in the parallels and comparisons that many commentators have drawn between these two men, the current president and his immediate predecessor, each the prohibitive favorite at this point to head his party’s ticket in the coming election. This proceeds from the unavoidable impression that some things must be broken in the United States for its two main political parties to have simultaneously offered up two such flawed candidates.

There is a world of difference in the ways in which they are flawed, though. The anxieties and discontent aroused by Biden’s performance, whether it is his frequent public memory lapses and misstatements or his shuffling gait and other signs of frailty, are perfectly normal. It is far from ideal for the United States to be led by someone with such traits, but there is nothing about the Biden presidency that conceivably threatens the future of the U.S. republic.

Like his politics or not, for this is not a partisan argument, Biden has presided over a smoothly functioning government that with few exceptions has executed its policies in competent and predictable ways. Other than the outlier factor of Biden’s age, history will likely regard his tenure as fitting firmly within the conventional bounds of U.S. politics. Even Biden’s potential death in office, which would be unsurprising given that, if reelected, he would be 82 years old on Inauguration Day, would yield a routine and proper succession by an elected vice president whom the American people would be free to throw out on the regular timetable should they choose to do so.

The case of Trump, though, couldn’t be more different. Whether one calls it an insurrection or not, the former president’s attempts to rally support for him to stay in power on January 6, 2021, or arm-twist lawmakers and his vice president to bend electoral rules for the same purpose were threats to the integrity of the U.S. political system. And they were not the only ones he has created, either. It is, of course, Trump’s right to defend himself against the many charges he faces in numerous courts of law, but one of his arguments should be seen as uniquely menacing—namely, that a president should be free from prosecution for any criminal behavior committed while in office.

The U.S. Supreme Court must now decide whether to consider the former president’s argument. A legal victory by Trump in this case, however unlikely, would spell the end of republican-style rule in the country by placing presidents above the law.

Trump has also positively invoked the word dictator in describing himself, unreassuringly justifying this by saying this aspiration would only apply to his first day back in office.

He has backed the state of Texas in refusing to comply with a federal court order asserting Washington’s control over the country’s borders, reportedly pledging to encourage other states to send their national guards to Texas to bolster its defiance of the United States’ federalist order. He is reportedly considering naming his daughter-in-law as head of the Republican Party, no crime to be sure, but a personalizing corruption of the political system in line with his other authoritarian instincts. And most recently, as the quote above shows, he has casually threatened members of the NATO alliance that if they don’t meet an agreed benchmark for defense spending, he would not only tolerate a Russian attack on them, but also encourage it.

Even taken individually, many of these positions or actions pose existential threats to the United States that are far more threatening that any concerns raised by Biden’s age. It is the NATO comment, though, that brings us back directly to the dissolution of the Soviet Union.

That country’s decay was brought on by the failure of its elites at renewal and reform. The ossification of its system was symbolized, if not exactly brought on, by the advanced age or poor health of its leaders in the pivotal moments of the 1980s. Economic growth in the Soviet Union was the envy of the world in the 1950s, and one might argue that, in fact, it was in the following decade that the country’s political system became too hidebound and corrupt to continue thriving.

Trump’s NATO rhetoric—and, should he become elected, his anti-alliance politics,—are even more damaging. They strike at the heart of U.S. success and prosperity in the world. If pursued, they would deliver a devastating blow to both the country and the global order, an own-goal with few historical parallels.

As filtered through Trump’s mind, alliances are like mob protection rackets in which the payments must keep flowing upward or back to the boss to keep him happy. Otherwise, he will allow bad things to happen, and the victims will have deserved their fate. Biden presents none of these risks.

There seems to be no recognition that the United States has been the premier beneficiary of its great alliances. Its former enemy Japan, for example, helped the United States in crucial, if indirect ways, in resisting North Korea’s takeover of the Korean Peninsula in the 1950s, and South Korea and Japan similarly helped Washington during the Vietnam War. Taken together, they and other allies in Asia are what allow the United States to maintain a favorable order and counterweight to China in the world’s most economically dynamic region.

NATO, likewise, has been similarly indispensable to U.S. power and preeminence in the North Atlantic. For decades, it has kept the peace in Europe and prevented renewed bids by Russia for imperial expansion. The accession of Sweden and Finland to the alliance that is now underway is not a sign of Washington being taken for a ride, as Trump might imagine, but rather a reaffirmation of U.S. power and vitality in the world. Enormous prosperity has flowed from this peace, as much to the United States as to the Europeans themselves.

Ukraine has been the one major exception in the post-Soviet era, and just as Trump seems to have no idea why the United States should help protect NATO members, he seems equally clueless about why allowing Ukraine to crumble before Moscow’s aggression should matter on the far side of the Atlantic.

I write this as someone who has spent a career freely criticizing Western imperialism, including the United States’ own. But if you want to overturn long-standing constitutional arrangements or the architecture of grand alliances, as Trump seems so inclined to do, you should have a coherent plan for alternatives. In a democracy, that should mean an exhaustive discussion and adherence to legal processes and informed choices at the ballot box. From Trump and many of his most ardent supporters, one hears no hint of anything beyond grievance and will to power. Matters of democracy fall by the wayside. All that remains is to follow the great leader.

Trump is a man who personalizes everything and seems to operate on impulses, whims, and grudges. If he is given a second chance to follow and execute them, in another decade or two, historians may be writing the kinds of books one can find today about the Soviet Union in the 1980s, all asking some version of the question: How did things go so completely off the rails?

The big difference, it seems, is that if this befalls the United States, it would be the result of an election in which voters choose a dangerous and incompetent leader—and one who is, moreover, nearly as old as Biden—and not a matter of elite mismanagement of an undemocratic succession. He would be enabled by members of his own party who have repeatedly shown little inclination to stand up to him on matters of constitutional or democratic principle.

Under such a grim scenario, it would not just be the conductor driving the train into the abyss, but also half the passengers, the station master, and the switch operators all contributing to the derailment.

[bvcirca]

BV Circa Medical Centre, Norwest: Comprehensive Healthcare Solutions 

BV Circa Medical Centre, situated in Norwest, is dedicated to delivering high-quality healthcare services to the community. This article explores the diverse range of Medical Centre Norwest, the experienced healthcare team, and the center's commitment to patient well-being. 

Comprehensive Medical Services 

BV Circa Medical Centre offers a comprehensive range of medical services designed to address various health needs: 

General Practice: Routine health check-ups, preventive care, and management of chronic conditions. 

Specialist Care: Access to specialists in areas such as cardiology, dermatology, and orthopedics. 

Women’s Health: Services include gynecological exams, family planning, and menopause management. 

Men’s Health: Prostate health, sexual health, and general men’s wellness. 

Children’s Health: Pediatric care, vaccinations, and developmental assessments. 

Mental Health: Counseling services, mental health assessments, and referrals to psychiatrists. 

Geriatric Care: Elderly health assessments, mobility aids, and management of age-related conditions. 

Chronic Disease Management: Comprehensive care plans for diabetes, hypertension, and other chronic illnesses. 

Experienced Healthcare Team 

The centre boasts a team of dedicated healthcare professionals committed to providing compassionate and effective care: 

General Practitioners (GPs): Primary healthcare providers offering ongoing management and treatment. 

Specialists: Experts in various medical fields, ensuring specialized care for complex health issues. 

Nurses and Allied Health Professionals: Supporting patient care through education, rehabilitation, and health promotion. 

Patient-Centered Care 

BV Circa Medical Centre adopts a patient-centered approach to healthcare delivery: 

Personalized Treatment Plans: Tailored to meet individual health needs and preferences. 

Holistic Care: Addressing physical, emotional, and social aspects of health. 

Health Education: Empowering patients with knowledge to make informed health decisions. 

Continuity of Care: Ensuring seamless coordination and follow-up for ongoing health management. 

State-of-the-Art Facilities 

The centre is equipped with advanced facilities to support comprehensive healthcare services: 

Diagnostic Services: On-site pathology and imaging services for accurate diagnosis. 

Treatment Rooms: Well-equipped for minor procedures and treatments. 

Telehealth Services: Virtual consultations for convenient access to healthcare. 

Community Engagement 

BV Circa Medical Centre actively engages with the community through health promotion initiatives and educational programs: 

Health Workshops: Providing information on wellness and disease prevention. 

Community Health Events: Promoting health awareness and early detection of medical conditions. 

Conclusion 

BV Circa Medical Centre in Norwest is committed to providing exceptional healthcare services tailored to the needs of the community. With a focus on patient-centered care, an experienced healthcare team, and advanced facilities, the center ensures comprehensive health solutions for all patients. 

To learn more about the services offered or to schedule an appointment, visit the BV Circa Medical Centre website or contact their friendly staff directly. 

[brooklynislandgirl]

Catcher in the rye!

Fragments || Accepting {Has your muse ever misjudged someone? Did they ever realize they had done so? What did they do to make amends?}

Beth laughs softly around the rim of her wine glass but the lack of eye-contact and the slightly larger sip than usual might offer visual proof that Kit has an amazing insight and definitely strikes a nerve. "I mean, of course I have. I'm sure it's less common f' you den is wi' me mostly because da ER is often a sort of petri-dish for opinions. Some beneficial, some malignant, an' all of 'em pretty gross mos' of da time." It's an honest assessment. The fact that the term GOMER {Get Out of My Emergency Room} even exists is a spotlight on both emergency room physicians who have either been dredged up from failed anger-management classes or who burnt out on the sheer amount of stress, to the very lack of resources and abilities to treat patients who might be down-and-out; those with addictions, alcohol dependency, senile or raging geriatrics, the overflow of unhoused people, and some are simply lonely and starving for human connection. Beth has heard the horror stories about memes posted about certain patient classifications, competitions of patients who have achieved their own lore and legend, pseudo-Olympics staged by bored or frustrated staff, and point systems. It's absolutely disgusting. Makes her wonder how some of these people ended up in the healing arts in the first place.

"An' of course, bein' in da position Andy an I are in, we have a lot of people who jus' wanna...well, take advantage of us, our position, an' so on. Sometimes dey jus' give off an aura of...sketch, if you know wha' I mean. So yeah. I guess too long, didn't read is probably, an' I really do feel bad when it turns out dat I was wrong. I am more likely t' apologise for it dan Andy is, d'ough."